"Double carbapenem" and oral fosfomycin for the treatment of complicated urinary tract infections caused by blaNDM -harboring Enterobacteriaceae in kidney transplantation

Rossana Rosa; Susan D Rudin; Laura J Rojas; Andrea M Hujer; Armando Perez-Cardona; Federico Perez; Robert A Bonomo; Octavio Martinez; Lilian M Abbo; Jose F Camargo

doi:10.1111/tid.12795

"Double carbapenem" and oral fosfomycin for the treatment of complicated urinary tract infections caused by bla_NDM -harboring Enterobacteriaceae in kidney transplantation

Transpl Infect Dis. 2018 Feb;20(1):10.1111/tid.12795. doi: 10.1111/tid.12795. Epub 2017 Nov 27.

Authors

Rossana Rosa^{1

2}, Susan D Rudin^{3

4}, Laura J Rojas^{3

5}, Andrea M Hujer^{3

4}, Armando Perez-Cardona⁶, Federico Perez³, Robert A Bonomo^{3

4

5

7

8

9}, Octavio Martinez¹⁰, Lilian M Abbo², Jose F Camargo²

Affiliations

¹ Department of Medicine, Jackson Memorial Hospital, Miami, FL, USA.
² Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, USA.
³ Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH, USA.
⁴ Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
⁵ Department of Microbiology and Molecular Biology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
⁶ Department of Microbiology, Jackson Memorial Hospital, Miami, FL, USA.
⁷ Department of Pharmacology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
⁸ Department of Biochemistry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
⁹ Department of Proteomics and Bioinformatics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
¹⁰ Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, USA.

Abstract

Infections with carbapenemase-producing carbapenem-resistant Enterobacteriaceae represent an emergent problem worldwide. Treatment of infections caused by New Delhi metallo-beta-lactamase (NDM)-harboring Enterobacteriaceae is particularly challenging as it frequently involves the use of nephrotoxic agents, which is problematic in kidney transplant recipients and non-renal transplant patients with marginal kidney function. We present two cases of urinary tract infections caused by NDM-harboring Enterobacteriaceae successfully treated with a combination of "double carbapenem" and oral fosfomycin.

Keywords: NDM; carbapenem-resistant Enterobacteriaceae; carbapenemase; fosfomycin; kidney transplant.

Publication types

Case Reports

MeSH terms

Anti-Bacterial Agents / administration & dosage
Anti-Bacterial Agents / therapeutic use
Carbapenems / administration & dosage
Carbapenems / therapeutic use*
Enterobacteriaceae / drug effects*
Enterobacteriaceae / enzymology
Enterobacteriaceae Infections / drug therapy*
Enterobacteriaceae Infections / etiology
Enterobacteriaceae Infections / microbiology
Fosfomycin / administration & dosage
Fosfomycin / therapeutic use*
Humans
Kidney Transplantation / adverse effects*
Male
Microbial Sensitivity Tests
Middle Aged
Treatment Outcome
Urinary Tract Infections / complications
Urinary Tract Infections / drug therapy*
Urinary Tract Infections / microbiology
beta-Lactamases / biosynthesis
beta-Lactamases / drug effects

Substances

Anti-Bacterial Agents
Carbapenems
Fosfomycin
beta-Lactamases
beta-lactamase NDM-1

Abstract

Publication types

MeSH terms

Substances

Grants and funding